The pharmaceutical retail industry is still subdued after the global financial crisis, however the industry has introduced various methodologies endeavouring to rectify the situation at hand. Although the introduction of online pharmaceuticals and automated dispensers has brought about a marginal level of relief to the industry, it has led to severe consequences for the traditional community pharmacies.
The Pharmaceutical Retail Industry (PRI) consists of businesses that retail prescription medications, patent drugs, cosmetics and toiletries. This industry is merely one subdivision of the overarching Retail Trade (RT) industry (Bankwest: 3).
While the international consumption levels of pharmaceutical products have stabilised following the global financial crisis (GFC), there remains organic factors that are keeping the consumption of pharmaceuticals passive compared to the powerful upswing recorded between 2002 and 2007 (Bankwest: 3). According to statistics released by the World Bank, South Africa had an average yearly spending rate of $362 per capita on pharmaceutical and healthcare products, in said time period (data.worldbank.org).
Following the GFC, families are struggling to manage and structure their salary expenditure in an everlasting attempt to afford the increasing costs of not only pharmaceutical products, but all additional living costs (Bankwest: 3). Based upon the annual 4,8% increase in the price of pharmaceuticals within South Africa (2016, health24.com), the average South African household can not afford to spend more than merely 1,9% of their total income on pharmaceutical and healthcare products (2013, StatsSa). As a result, this has caused a major setback to the South African pharmaceutical retail industry.
In order for the PRI to attempt sustainable growth, the industry has introduced various different methodologies to bring down the price of pharmaceutical products to the end user. Although this might be advantageous to the end user, it may have detrimental consequences for the traditional community pharmacy. The first of these methodologies being the “online pharmacy’.
Seen as the next “big challenge”, parliamentary changes combined with higher demand from “convenience focussed” consumers, could potentially cause havoc to the traditional community pharmacies (Bankwest: 3). In Robert Whitaker’s article Buying pills on the net, he argues that the success behind the online pharmaceutical market resides within the aspect of convenience (Whitaker, 2009). He explains that purchasing medication online offers the client the opportunity to not only conduct their business from the comfort of their own home, but provides them with the opportunity to “shop around” for the cheapest available option (Whitaker, 2009). Mark Davison, opposes Whitaker’s views by arguing that the online pharmaceutical trade has major concerns, one of which being the outdated and substituted medications that are often sent to the end user as a result of the lack of reliable pharmacists’ input, support and advise (Davison, 2001: 426).
An alternative approach endeavouring to support growth within the pharmaceutical retail industry is born from the recent successful trials in remote dispensing machines (Fitzgerald: 9). These machines are used to describe automated dispensing systems that package and label prescription medications as well as cosmetics and toiletries, without an on-site pharmacist. In their journal article Can telepharmacy provide pharmacy services in the bush?, Nissen and Tett argue that although the same elements of convenience apply to these machines as to the online pharmacy, this method of attaining pharmaceutical products has its own set of challenges that requires further investigation. They claim that these machines place a barrier between the pharmacist and the patient that could potentially lead to fatal consequences (Nissen & Tett, 2003: 9). They explain in an example that a patient with alcohol on the breath will go unnoticed by the remote dispenser. This might cause fatal interactions between the alcohol and various medications such as sleeping tablets, tranquilisers and narcotics (Nissen & Tett, 2003: 9). Louise Slabbert, South African based doctor of dentistry, concurs on the views as set out by Nissen and Tett. Her principle concern with both the automated dispensing system and the online pharmacy is more focused on the effects of dispensing medication without the presence of a pharmacist that is familiar with the patient and his/her family’s medical background (Slabbert, 2017).
Although the PRI has taken some drastic measures to ensure sustainable growth, it seem that although these measures might be detrimental to the community pharmacies, the abovementioned systems are still far from acting as a replacement for the community pharmacy. But the question that still remains, is an ethical one. – Can the PRI afford to rid the bond of trust between pharmacist and patient?